Microkhan by Brendan I. Koerner

My previous posts about suicide haven’t been particularly cheery, and not just because of the grim subject matter. Everything I’ve seen in recent years has convinced me that our current anti-suicide measures aren’t working particularly well, given the stability of America’s suicide rate over the past half-century. It’s quite discouraging to realize that innovations such as bridge-side barriers may not be so effective after all.

But the news out of South Asia offers a reason for hope. Sri Lanka was able to halve its suicide rate between 1995 and 2005, simply by banning the import of a particularly lethal class of pesticides. Incredibly, this reduction occurred even as the number of reported cases of self-poisoning by pesticide increased. The attempts simply fell short because people were relegated to ingesting less toxic substances than before the prohibition. The implications are discussed here:

There is a growing body of evidence showing that changes in the availability of a commonly used method of suicide may influence not only method-specific, but also overall suicide rates. The strongest evidence for this comes from the natural experiment afforded by the detoxification of the domestic gas supply in Britain in the 1960s. Similar effects on method specific and overall suicides have been documented following the enactment of gun-control legislation and restricting the availability of barbiturates in Australia.

The most relevant example of the influence of the easy availability of lethal methods of suicides in relation to pesticide suicide comes from Western Samoa. In the 1970s and 80s there were marked fluctuations in Western Samoa’s imports of paraquat, a pesticide associated with a particularly high case-fatality (>60%). These variations closely followed rise and falls in fatal episodes of paraquat self-poisoning and overall suicide. Indeed in the late 1970s/early 1980s, the period associated with the highest levels of paraquat imports, paraquat suicides accounted for around three quarters of suicides in West Samoa.

The paper ends by encouraging the likes of India and China to follow Sri Lanka’s lead in banning the import of the most dangerous pesticides—or, at the very least, to limit access to licensed users. Based on the figures from Sri Lanka, as well as the depressing annual stats regarding suicides by pesticide, such measures could literally save tens of thousands of lives each year.